Cognitive impairment, commonly found among substance abusers, may reduce the effectiveness of manualized psychosocial treatments. If so, tailoring such treatments to the patients' needs should improve effectiveness. The goal of this mentored clinical scientist award is to enhance the developing clinical research skills of Efrat Aharonovich, Ph.D. through research on cognitive deficits and manualized psychosocial treatments for substance abuse patients. In 2001, Dr. Aharonovich joined the faculty in the Division as Assistant Professor of Clinical Psychology in Psychiatry. Her pilot studies on cognitive functioning and treatment outcome in substance abuse patients provide preliminary support for her hypothesis that cognitive functioning affects treatment outcome. Dr. Aharonovich is co-PI on a NIDA-funded study of depressed heroin addicts, and she will shortly receive NIDA funds for an exploratory study of cognitive deficits and treatment outcome in non-depressed cocaine abusing patients. However, to become an independent clinical researcher, Dr. Aharonovich will need formal course work, mentoring, and release of time from her extensive clinical and administrative responsibilities so that she can concentrate on developing her own research. In the next several years, Dr. Aharonovich plans to conduct mentored formative research and clinical treatment trials of behavioral interventions modified for cognitively impaired substance abusers. This research and additional training will prepare Dr. Aharonovich well to meet her long-term research career goal of improving the effectiveness of behavioral interventions for substance abuse patients. Under the sponsorship and guidance of Dr. Edward Nunes, together with other Columbia University faculty, Dr. Aharonovich's training plan combines formal course work with clinical research experience. She will work closely with several preceptors to receive training in the following areas: methods of conducting clinical treatment trials, neuropsychological assessment batteries for substance abusers, instrument development, study design and interpretation, and biostatistics. Her research plan includes a study of the effects of cognitive deficits on the outcome of Cognitive Behavioral Therapy (CBT) in substance abuse patients, the use of this information to tailor CBT for cognitively impaired substance abuse patients, and a randomized clinical trial of the effectiveness of the modified CBT. The combined mentoring, training and research plan will provide Dr. Aharonovich with unique training, and will afford her the opportunity to develop an independent clinical research career focused on the development of new behavioral approaches to the treatment of substance abuse disorders.